Validating the diagnostic performance of MUAC in screening moderate acute malnutrition and developing an optimal cut-off for under five children of different regions in Ethiopia

Background Valid and reliable anthropometric indicator is useful for early detection and treatment for under nutrition. Although, mid upper arm circumference (MUAC) is used for screening of children with moderate acute malnutrition in Ethiopia, its performance for the different ethnic groups has not been evaluated. Objective To determine the diagnostic performance of MUAC for determination of moderate wasting among children of different ethnic background and develop optimal cut-off. Methods A community based cross-sectional study was conducted among under five children of the three regions namely: Somalia, Amhara and Gambella Regions. The diagnostic performance of MUAC was validated using weight for height Z-score< -2 as a gold standard binary classifier. Test variable is mid upper arm circumference (MUAC< 12.5cm) and weight for height Z-Score (WHZ) is standard variable. ROC analysis performed based on the assumptions of MUAC value lower the cut-off point indicates the undernutrition. Area under the curve and validity measures (sensitivity and specificity) was generated as parameter estimated. The results were presented using tables and ROC curves. Results Except in the Gambella region, there was fair agreement between MUC